Please answer all items. Your answers will be e-mailed to Karin Kramer and kept confidential.

Your ID Number (as assigned by Karin)

Was there ever a time in your life when you felt sad, down, or depressed almost every day for a period of AT LEAST TWO YEARS?

Was there ever a time in your life when you felt sad, down, or depressed every day for AT LEAST TWO WEEKS?

In the PAST TWO YEARS, I've felt depressed or unhappy on most days.

In the PAST TWO YEARS, I've felt sad, blue, or down most of the time.

In the PAST TWO WEEKS, I've been feeling down or depressed nearly every day.

In the PAST TWO WEEKS, I've lost interest in nearly all pleasurable or rewarding activities.

In the PAST TWO WEEKS, I've been feeling hopeless.

In the PAST TWO WEEKS, feelings of depression have been distressing or upsetting to me.

In the PAST TWO WEEKS, feelings of depression have been causing problems in my work, relationships, or activities.

In the PAST TWO WEEKS, at times I've had thoughts or fantasies of killing myself.

In the PAST TWO WEEKS, at times I've had the urge to commit suicide.

In the PAST TWO WEEKS, I've had a poor appetite

In the PAST TWO WEEKS, I've been overeating.

In the PAST TWO WEEKS, I've had trouble sleeping.

In the PAST TWO WEEKS, I've been sleeping too much.

In the PAST TWO WEEKS, I've had trouble concentrating or making decisions.